Óleos de peixe e aterosclerose

Autores

  • José Manuel Silva Assistente Hospitalar Eventual de Medicina Interna, Hospitais da Universidade de Coimbra
  • José Brito Interno do Internato Complementar de Pneumologia, Hospitais da Universidade de Coimbra
  • Pedro Figueiredo Interno do Internato Complementar de Gastroenterologia, Hospitais da Universidade de Coimbra
  • Ávila Costa Assistente Hospitalar Graduado de Medicina Interna, Hospitais da Universidade de Coimbra
  • Políbio Serra e Silva Prof. Catedrático da Faculdade de Medicina de Coimbra, Serviço de Medicina ll dos Hospitais da Universidade de Coimbra

Palavras-chave:

óleos de peixe, ácidos gordos ome­ga 3, ácido eicosapentanóico, aterosclerose

Resumo

Estudos epidemiológicos demonstram uma signi­ ficativa correlação inversa entre o consumo de pei­xe e a doença aterosclerótica. Fracção importante dos óleos de peixe, os ácidos gordos omega 3, par­ ticularnente o ácido eicosapentanóico, parecem ser os mediadores dessa acção, que seria consequên­ cia de vários efeitos metabólicos, nomeadamente:

1) actividade hipolipemiante, diminuindo a síntese de triglicerídeos; 2) antiagregante plaquetar, devi­do à síntese de tromboxano A3 em detrimento do A2; 3) anti-inflamatória, pela diminuição da síntese de leucotrieno B4, um potente agente quimiotático de neutrófilos e monócitos, e aumento da síntese de leucotrieno B5; 4) antitrombótica, reduzindo os níveis de PAI-1 efibrinogénio; 5) melhoria da per­ fusão dos tecidos. O consumo de concentrados de óleos de peixe parece ser praticamente inócuo, com a hipotética excepção dos diabéticos, na medida em que poderá piorar o controlo glicémico.

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Referências

Bang H O Coronary heart disease and Q-3: epidemiological as­pects Em: Fish oil and blood-vessel wall interactions, Eds. PM Vanhouttc, Ph Douste-Blazy.John Libbey Eurotext, Paris 1991; PP 109-116.

Israel DH, Gorlin R Fish oils in the prevention of atherosclerosis. J Am Coll Cardiol 1992; 19: 174-185.

Burr ML Fish anel ischaemic hearl eliseasc Em: Nutrition and fit­ness in health anel disease, Simopoulos AP (eel.), World Rev Nutr Diet, Basel, Karger 1993; 72: 49-60.

Mordoy A Is there a rational use for n-3 fatty aciels (fish oils) in clinicai medicine? Drugs 1991; 42 (3): 331-342.

Davidson MH, Bums JH, Subbaiah PV, Conn ME, Drennan KB Marine il capsule therapy for the tratment of hyperlipielemia Arch lntern Med 1991: 151: 1732-1740.

Leaf A, Weber PC Cardiovascular effects of n-3 fatty acids. N Engl J Meel 1988: 318: 549-557

Willumscn K, Hexeberg S, Skorve J, Lundquist M, Berge RK Do­ cosahexaenoic acid shows no triglyceride-lowering effects but increases the peroxisomal fatty acid oxidation in liver of rats. J Lipid Res 1993: 34: 13-22.

Otten W, Wirth C. Iaizzo PA, Eichinger HM. A high omega 3 fatty acid diet alters fatty acid composition of heart, liver, kidney, adipose tissue anel skeletal muscle in swine. Ann Nutr Metab 1993: 37 134-141.

Schmielt F.B n-3 polyunsaturatecl fatty aciels anel ischaemic heart disease. Curr Op Lipidol 1993: 4: 27-33

Harris WS. Muzio F. Fish oil recluces postprandial triglyceride concentrations without accelerating lipidemulsion remova! rates. AmJ Clin Nutr 1993: 58: 68-74.

Harris WS. Connor WE. Alam N, Dlingworth DR. Reduction of rostprandial triglycceridemia in humans by elieta1y n-3 fatty acids J Lipid Res 1988; 29: 1451-1460.

Von Schacky C. Fishér S, Weber PC. Long terrn effects of clietary omega-3 fatty acids upon plasma and cellular lipiels, platelet function anel eicosanoiel formation in man. J Clin Invest 1985; 76: Hí26-1631.

Knapp HR. Reilly IAG, Alessandrini P, Fitzgerald GA. ln-vivo in­ dexes on platelet and vascular function during fish oil administration in patients with atherosclerosis. N Engl J Mecl 1986; 314:937-942

Fisher S, Weber PC. Prostaglanclin B is formed in-vivo in man after clieta1y eicosapentanoic acid. Nature 1984: 307: 165-168.

Scmidt EB, Pederson JO,Jersild C, Ditzel J, Grunnet N, Dyerberg J. The effect of n-3 polyunsaturated fatty acids on lipids, haemos­tasis, neutrophil and monocyte chemotaxis in insulin depen­ dent diabetes mellitus. J lntern Med (suppl) 1989; 225: 201-206.

Fox PL. DiCorleto PE. Fish oil inhibit endothelial cell production of platelet-derived growth factor-like protein. Science 1988; 241: 453-456.

Shimokawa H, Vanhoutte PM. Dietary cod-liver oil improves endothelium dependem responses in hypercholesterolemic anel atherosclerotic porcine coronary arteries. Circulation 1989; 78: 1421-1430

Fleishauer FJ, Lee TC, Wellesson U, Fischell TA. Fish oil improves enclothelium-dependent coronary vasodilation in cardiac transplant recipients. Circulation 1990: 82 (suppl III): III 468 (abstr.)

McVeigh GE, Brennan GM,Johnston GD, McDermott BJ, McGra­th LT, Henry WR, Andrews JW, Hayes JR. Dietary fish oil augments nitric oxide production or release in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1993; 36: 33-38.

Mehta J, Lawson D, Saldeen T. Reduction in pasminogen activa­tor inhibitor-1 (PAI-1) with omega-3 polyunsaturated fatty acids (PUFA) intake. Am HeartJ 1988; 116: 1201-1206.

Hostmark AT, Bjerkeclal T, Kierulf P, Flaten H, Ulshagen K. Fish oil and plasma fibrinogen Br Med J 1988: 297 180-181.

Raclack K, Deck C, Huster G. Dietary supplementation with low­ close fish-oil lowers fibrinogen leveis: a randomized, douhle­ blind controlled study. Ann Intern Med 1989; 111: 757-7-,8.

Prevention of coronary heart disease: scientific background and new clinical guidelines. Recommendations of the European Atherosclerosis Society prepared by lhe international task for­ce for the prevention of coronary heart disease. Nutr Metab Cardiovasc Dis 1992; 2: 113-156.

Lorentz R, Spengler V, Fischer S, Duhn.J, Weber PC. Platelet func­tion, thromboxane formation and blood. pressure control during supplementation of the Western diet with cod liver oil. Circulation 1983; 67: 504-511.

Engler MB, Engler MM, Ursell PC. Vasorelaxant properties of n-3 polyunsaturated fatty acids in aortas from spontaneously hypertensive and normotensive rats. J Cardiovascular Risk. 1994; 1(1 ): 75-80

Enrst E. Effects of n-3 fatty acids on bloodrheology. Journal of Internal Medicine 1989; 225 (suppl 1 ): 129-132.

B0naa KH, Bjerve KS, Straume B, Gram IT, Thelle D. Effect of eicosapentanaeoic anel elocosahexaenoic acids on blood pressure in hypertension: a population-based intervention triai from the Tromso Study. N Engl J Mecl 1990: 322: 79-,-801.

Moms MC, Sacks F, Rosner B. Does fish oil lower blood pressu­re1 A meta-analysis of controlled trials. Circulation 1993: 88: 523-533

Lofgren RP, Wilt 1], Nicho! KL, Crespin L, Pluhar R. Eckfeldl J. The effect of fish oil supplements on blood pressure. Am J Public Health 1993: 83: 267-269

Nozaki S, Kubo M, Takemura K, Matsuzawa Y, Tarui S. Effects of purified eicosapentaenoic acid ethyl ester (EPA) on lipoprotein composition. Circulation 1990; 82. (supll III): III 477 (abstr.)

Lorgeril M, Renaucl S, Mamelle N, Salen P, MartinJL, Monjaud I. Guiclollet J, Touboul P, Delayej. Mediterranean alpha-linole­ nic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343; (8911): 1454-1459.

Hock CE, Holahan MA, Reibel DK. Effect of dietary fish oil on myocardial phospholipds and myocardial ischemic damage. Amj Physiol 1987; 252: 554-560.

Matsukura T, Miyagawa M, Satoh K, Mineo S, Yanagisawa A. lshikawa K. Effect of dietary fish oil on infaret size in feline myocardial ischemia. Circulation 1990; 82 (suppl III): III 39 (abstr.).

Dehmer GJ, PopmaJJ, Van Den Berg EK, Eichhom EJ, Prewilt JB, Campbell WB, Jennings L, Willerson JT, Schmitz JA. Reducti­on of the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Engl J Med 1988: 319: 733-740

Grigg LE, Kay TWH, Valentine PA, Larkings R, Flower DJ, Mano­ las EG, O'Dca K, Sinclair AJ, Hopper JL, Hunt D. Determi­nants of restenosis and lack o effect of dietary supplementati­on with eicosapentaenoic acid on the incidence of coronary artery restenosis after angioplasty. J Am Coll Cardiol 1989;13: 665-672.

Gapinski JP, VanRuiswyk JV, Heudebert GR, Schectman GS. Pre­venting restenosis with fish oils following coronary angioplas­ ty. A mela-analysis. Arch lntern Med 1993; 153: 1595-1601.

Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweet­ man PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: die and reinfarction triai (DART). Lancet 1989; 2: 757-761.

Seidelin KN, Myrup B, Fischer-Hansen B. n-3 fatty acids in adi­pose tissue and coronary artery disease are inversely related. Am J Clin Nutr 1992; 55: 1117-1119.

Dolecek TA. Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multi­ple risk factor intervention trial. Proc Soc Exp Biol Med, 1992; 200: 177-182.

Lorenz R. Q-3 fatty acid and risk of atherosclerosis. Em: Fish oi! and blood-vessel wall interactions, Eds. PM Vanhoutte, Ph Douste-Blazy.John Libbey Eurotext, Paris 1991; pp: 133-139.

Jensen T, Stender S, Goldstein K, Holmer G, Deckert T. Partial normalisation by dietary cod-liver oil of increased microvas­ cular albumin leakage in patients with insulin-dependent dia­ betes and albuminuria. N Engl J. Med 1989; 321: 1572-1577.

Berthezene F. Q-3 fatty acid and diabetes mellitus" Em: "Fish oil and blood-vessel wall interactions, Eds. PM Vanhoutte, Ph Douste-Blazy. -John Libbey Eurotext, Paris 1991; pp:129-131.

Kristensen SD, De Caterina R, Schmidt EB, Endres S. Fish oil and ischaemic heart disease. Br Med J 1993; 70: 212-214.

Suzukawa M, Abbey M, Nestel PJ Effect of fish oil fatty acids on LDL size, oxidizability and uptake by macrophages. Atheros­clerosis 1994; 109: 73.

Goodnight SH, Fisher M, Fitzgerald GA, Levine P. Assessment of therapeutic use of dietary fish oil in atherosclerotic vascular disease and thrombosis. Chest 1989; 95 (suppl 2) 19S-25S.

Glauber H, Wallace P, Griver K, Bretchel G. Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabe­tes mellitus. Ann lntern Med 1988; 108: 663-668.

Svensson BG, Nilsson A, Hansson M, Rappe C, Akesson B, Sker­fving S. Exposure to dioxins and dibenzofurans through the consumption offish. N Engl J Med 1991; 324: 8-12.

McKeigue P. Diets for secondary prevention of coronary heart disease: can linoleic acid substitue for oily fish. Lancet 1994; 343 (8911): 1445.

Ozerova IN, Shuvaeca TI, Kalinkina OM, Perova NV, Oganov RC. Long-term intake of fish-enriched diet in patients with co­ronary heart disease. Atherosclerosis 1994; 109: 72.

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Publicado

31-03-1995

Como Citar

1.
Silva JM, Brito J, Figueiredo P, Costa Ávila, Serra e Silva P. Óleos de peixe e aterosclerose. RPMI [Internet]. 31 de Março de 1995 [citado 24 de Abril de 2024];2(1):33-8. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/2342

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